* Fetal Mobile: the biparietal diameter and 9.5cm in diameter occiput bregamatique 6.5cm successively represent the transverse and anteroposterior diameter of a well-flexed head.
* Bone Bassi: The brim is presenting engagement plan, it is limited in front by the posterior superior portion of the pubic symphysis, laterally by the lines and innominées back by the promontory. Its dimensions are represented by the retropubic promonto-diameter (10.5 cm) and the transverse median diameter (12.5 cm).
The sum of these two diameters sets the index Magnin (≥ 23 cm).
The excavation is the bony cavity in which the presentation makes the descent and rotation (bi-thorny diameter or bi-sciatic average 11 cm). The pelvic outlet is the presentation release release online, it is limited in front by the lower edge of the pubic symphysis, laterally by the ischial and back through the tip of the coccyx.
TYPE OF DELIVERY:
The term is fixed between 38 and 42 SA SA; Beyond this is the post-term before it’s premature birth.
There is talk of delivery if the fetus is viable, or after 22 weeks the fetus or> 500g according to WHO (1000 g or 28 weeks at home).
Before this term, it is called late abortion.
The vertex cephalic presentation is flexed, the most frequent (96%) and most eutocic.
It is useful to identify the occiput through the posterior fontanelle (lambda), the position of the mark with respect to the maternal pelvis defines varieties presentations.
Earlier varieties: LOA (most frequent 57%) and ROA (4%); the posterior varieties: LOA and OIDP (33%); the LOA and the OIDP undertake in the left oblique diameter.
PHASES OF DELIVERY:
* The work is to define the coexistence of three elements: the cervix is changing is the erasure, the lower segment distends (compliance) and myometrium contracts (uterine contractions).
These changes occur in the order in primiparas in multiparas while clearing the pass and the compliance of the lower segment are performed simultaneously.
They are often associated with more or less mucous bloody losses (loss of mucus plug); the uterine contractions become regular, frequent and painful, about every 5 minutes.
Bishop score objective cervical changes. The cervix is favorable when it says score ≥ 7.
Monitoring of the presentation is provided by the vaginal. The occiput and the suture are anteroposterior pins presentation, the ischial spines define the zero level: line of scrimmage.
The second phase consists of three phases: engagement presentation, decent and rotation, then its release.
Commitment is defined by crossing the brim with the presentation, the sign of Farabeuf is the most used sign: the TV, the presentation is said to be engaged if two fingers introduced in the symphysis and directed to the 2nd sacred piece arrested by it, this sign is questionable whether there is a sero-bloody bump.
The sign of Le Laurier by abdominal palpation (the presentation is considered committed only if we can place 2 fingers between fetal anterior shoulder and the upper edge of the fetal symphysis).
Descent and rotation are a concomitantly; the descent takes place along the axis of umbilico-coccygeal engagement in a first step, then due to the contact with the sacrum the axis of the descent horizontalizes.
Earlier presentations will rotate 45 °, while the later presentations will perform a 135 ° angle to coincide diameter sub-occipital bregmatic with pubococcygeus diameter.
The release takes place mostly in occipital-pubic (98%), the head performs a gradual deflection; the release of the shoulders and starts the previous posterior shoulder.
* The issue is the expulsion of the fetal annexes (placenta and membranes of the egg).
It evolves in 3 phases: peeling dependent uterine con-tractions after the expulsion of the child, and finally expulsion hemostasis provided by the uterine contraction (effective only if the uterus is completely evacuated) and blood coagulation phenomena.
The grant is made in a manual or artificially if it exceeds 30 min.